Tailoring treatment for early gastric cancer after endoscopic resection using sentinel node navigation with infrared ray electronic endoscopy combined with indocyanine green injection

Dig Surg. 2009;26(4):276-81. doi: 10.1159/000227766. Epub 2009 Jul 8.

Abstract

Background: This study evaluated the efficacy of sentinel node navigation surgery using infrared ray electronic endoscopy (IREE) combined with indocyanine green in patients after endoscopic treatments of early gastric cancer.

Methods: 14 patients with early gastric cancer after endoscopic treatments were included. Each patient underwent sentinel node navigation surgery using IREE. Sentinel node detection rate, accuracy of sentinel node metastases and clinical efficacy including the presence or absence of recurrence were evaluated.

Results: The intraoperative sentinel node detection rate was 100% (14/14), and accuracy for sentinel node metastases was 93% (13/14). Based on the results of sentinel node mapping, 2 patients received standard gastrectomy with D2 lymphadenectomy, and the remaining 12 patients underwent limited surgery with lymphatic basin dissection. After median follow-up of 32 months, no patients had tumor recurrence.

Conclusion: The validity of limited surgery based on sentinel node navigation for early gastric cancer remains unclear because the results of a well-designed multicenter clinical trial of sentinel node mapping for gastric cancer have not yet been reported. However, this study suggests that sentinel node navigation surgery using IREE combined with indocyanine green is useful for early gastric cancer after endoscopic resection.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Coloring Agents
  • Early Detection of Cancer / methods
  • Endoscopy, Gastrointestinal / methods*
  • Female
  • Follow-Up Studies
  • Gastroscopy / methods
  • Humans
  • Indocyanine Green
  • Infrared Rays
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Sentinel Lymph Node Biopsy / methods*
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*
  • Treatment Outcome

Substances

  • Coloring Agents
  • Indocyanine Green